title: Cardiovascular effects of antimuscarinic agents in overactive bladder.
abstract: BACKGROUND
  The potential impact of antimuscarinics (AMs) on cardiac function is a major concern in the treatment of overactive bladder (OAB) patients, especially in older ones who are likely to present cardiovascular (CV) comorbidities and other risk factors that may predispose them to the adverse cardiac effects of this therapy.
  
  
  METHODS
  This article aims to review the literature on the impact on the CV system of AMs used in the treatment of OAB, giving a comprehensive explanation of the pathogenetic mechanisms of AMs' effects on CV system and the impact of each AM drug on cardiac function.
  
  
  CONCLUSIONS
  Although the CV safety of AM drugs seems to be good, evidence provided in this manuscript does not allow to exclude an increase in HR, QT prolongation or an increase in the CV risk due to drug-drug interactions in OAB patients who are usually elderly and have comorbidities. Clinical and electrocardiographic monitoring may be necessary throughout the administration period in selected populations such as patients aged > 80 years, those with coronary heart disease or congestive heart failure. Further studies are needed to understand whether the most recently developed AM drugs, such as imidafenacin, are safer than the old ones.
authors.affiliation: University of Genoa, San Martino Hospital and National Institute for Cancer Research, Department of Cardiology , Genoa , Italy simone.ferrero@unige.it.
authors.forename: Gian Marco
authors.initials: GM
authors.lastname: Rosa
authors.forename: Matteo
authors.initials: M
authors.lastname: Bauckneht
authors.forename: Carolina
authors.initials: C
authors.lastname: Scala
authors.forename: Emanuela
authors.initials: E
authors.lastname: Tafi
authors.forename: Umberto
authors.initials: U
authors.lastname: Leone Roberti Maggiore
authors.forename: Simone
authors.initials: S
authors.lastname: Ferrero
authors.forename: Claudio
authors.initials: C
authors.lastname: Brunelli
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002318:Cardiovascular Diseases / Q000139:chemically induced* / Q000503:physiopathology; D004347:Drug Interactions; D016903:Drug Monitoring / Q000379:methods; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D018727:Muscarinic Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D012307:Risk Factors; D053201:Urinary Bladder, Overactive / Q000188:drug therapy*
chemical_list: D018727:Muscarinic Antagonists